<?php echo $header; ?>
<?php if ($error_warning) { ?>

<div class="warning"><?php echo $error_warning; ?></div>
<?php } ?>
<?php echo $column_left; ?><?php echo $column_right; ?>
<div id="content"><?php echo $content_top; ?>
	<div class="box">
		<div class="breadcrumb">
			<?php foreach ($breadcrumbs as $breadcrumb) { ?>
			<?php echo $breadcrumb['separator']; ?><a href="<?php echo $breadcrumb['href']; ?>"><?php echo $breadcrumb['text']; ?></a>
			<?php } ?>
		</div>
		<h1><?php echo $heading_title; ?></h1>
		<p><?php echo $text_description; ?></p>
		<form action="<?php echo $action; ?>" method="post" enctype="multipart/form-data">
			<table class="form">
				<tr>
					<td><span class="required">*</span> <?php echo $entry_to_name; ?></td>
					<td><input type="text" name="to_name" value="<?php echo $to_name; ?>" />
						<?php if ($error_to_name) { ?>
						<span class="error"><?php echo $error_to_name; ?></span>
						<?php } ?></td>
				</tr>
				<tr>
					<td><span class="required">*</span> <?php echo $entry_to_email; ?></td>
					<td><input type="text" name="to_email" value="<?php echo $to_email; ?>" />
						<?php if ($error_to_email) { ?>
						<span class="error"><?php echo $error_to_email; ?></span>
						<?php } ?></td>
				</tr>
				<tr>
					<td><span class="required">*</span> <?php echo $entry_from_name; ?></td>
					<td><input type="text" name="from_name" value="<?php echo $from_name; ?>" />
						<?php if ($error_from_name) { ?>
						<span class="error"><?php echo $error_from_name; ?></span>
						<?php } ?></td>
				</tr>
				<tr>
					<td><span class="required">*</span> <?php echo $entry_from_email; ?></td>
					<td><input type="text" name="from_email" value="<?php echo $from_email; ?>" />
						<?php if ($error_from_email) { ?>
						<span class="error"><?php echo $error_from_email; ?></span>
						<?php } ?></td>
				</tr>
				<tr>
					<td><span class="required">*</span> <?php echo $entry_theme; ?></td>
					<td><?php foreach ($voucher_themes as $voucher_theme) { ?>
						<?php if ($voucher_theme['voucher_theme_id'] == $voucher_theme_id) { ?>
						<input type="radio" name="voucher_theme_id" value="<?php echo $voucher_theme['voucher_theme_id']; ?>" id="voucher-<?php echo $voucher_theme['voucher_theme_id']; ?>" checked="checked" />
						<label for="voucher-<?php echo $voucher_theme['voucher_theme_id']; ?>"><?php echo $voucher_theme['name']; ?></label>
						<?php } else { ?>
						<input type="radio" name="voucher_theme_id" value="<?php echo $voucher_theme['voucher_theme_id']; ?>" id="voucher-<?php echo $voucher_theme['voucher_theme_id']; ?>" />
						<label for="voucher-<?php echo $voucher_theme['voucher_theme_id']; ?>"><?php echo $voucher_theme['name']; ?></label>
						<?php } ?>
						<br />
						<?php } ?>
						<?php if ($error_theme) { ?>
						<span class="error"><?php echo $error_theme; ?></span>
						<?php } ?></td>
				</tr>
				<tr>
					<td><?php echo $entry_message; ?></td>
					<td><textarea name="message" cols="40" rows="5"><?php echo $message; ?></textarea></td>
				</tr>
				<tr>
					<td><span class="required">*</span> <?php echo $entry_amount; ?></td>
					<td><input type="text" name="amount" value="<?php echo $amount; ?>" size="5" />
						<?php if ($error_amount) { ?>
						<span class="error"><?php echo $error_amount; ?></span>
						<?php } ?></td>
				</tr>
			</table>
			<div class="buttons clearafter">
				<div class="right">
					<input type="submit" value="<?php echo $button_continue; ?>" class="button" />
				</div>
				<p>
					<?php if ($agree) { ?>
					<input type="checkbox" name="agree" value="1" checked="checked" />
					<?php } else { ?>
					<input type="checkbox" name="agree" value="1" />
					<?php } ?>
					<?php echo $text_agree; ?> </p>
			</div>
		</form>
	</div>
	<?php echo $content_bottom; ?></div>
<?php echo $footer; ?>